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Europe recently took bold measures to put public health ahead of commercial interests. In 1998, the European Union banned antibiotics important in human medicine from use as growth promoters in livestock production. The United States, facing the same threat and the same strong industry opposition, lags far behind in its response.
The Threat


Imagine taking your child to the doctor for food poisoning, only to be told that it has spread to her bloodstream (a not infrequent complication of food poisoning) and that no antibiotics are available for treatment. The antibiotics on the pharmacist's shelf can't help her because the Salmonella bacteria making her ill have become impervious to them. As far as your child is concerned, the once-formidable arsenal of miracle drugs is now a set of useless potions. Lacking effective antibiotics, she could become much more ill or even die.
This scenario is not farfetched. Evidence continues to mount that antibiotic arsenals are being depleted due to the development of resistant organisms. A recent two-year study of chicken from grocery stores in Minnesota connected a significant increase in antibiotic-resistant Campylobacter (a food-borne bacteria) to drug use in poultry production. The more microorganisms that become resistant to antibiotics, the greater the risk of a resurgence of untreatable infectious disease. Public health officials and scientists know well the cause of resistance to antibiotics. It's overuse -- not only in human medicine, the primary locus of the problem, but also in agriculture. In fact, the Centers for Disease Control consider the agricultural use of antibiotics to be the major cause of antibiotic resistance in food-borne illness.

It may come as a surprise, but something like 80 percent of agricultural antibiotics are used not to treat sick animals but merely to promote efficient growth of chickens, cows, and pigs. If society is to reduce its use of antibiotics to minimize the evolution of resistant organisms, growth promotion in agriculture is a good place to start. Its benefits are economic, not health-related -- and minor in any case. Although antibiotic use is entrenched in modern livestock production, it is not essential for reasonably priced, high-quality meat.

Action in Europe


While officials in the United States are beginning, timidly, to address this issue, the European Union has already taken decisive action. As of 1998, the EU prohibited use of all antibiotics used in human medicine for animal growth promotion. Furthermore, it authorizes only four antibiotics not used in human medicine for agricultural use without prescription. The United States, by contrast, allows 19 different antibiotics to be used for growth promotion. Of these, at least 7 drugs are used in human medicine, including penicillin, streptomycin, and virginiamycin.
European and multinational drug companies that stood to lose hundreds of millions of dollars from the EU's new regulations strongly opposed the ban. The manufacturers of virginiamycin and bacitracin sued for a repeal of the ban, but the suits were dismissed. Although the Centers for Disease Control in Atlanta has judged the EU's actions to be based on sound science, the US trade representative, apparently acting at the behest of US pharmaceutical and meat companies, has threatened to challenge the ban as an illegal trade barrier before the World Trade Organization.

Tales from Europe


The recent wave of EU activity on antibiotics followed the entry of Sweden and Finland -- both countries with strong restrictions on antibiotic use in livestock -- into the European Union. While joining the EU could have led to a watering down of standards in those countries, the opposite has happened. As EU member countries, Sweden and Finland retained their own restrictions on antibiotics and asked that the EU "harmonize upwards" by removing more drugs from the EU list of authorized feed additives.
Their experience shows that the United States has much to gain -- and to learn -- from European success stories.